Medical Surgical Nursing MCQ Quiz - Objective Question with Answer for Medical Surgical Nursing - Download Free PDF

The correct answer is:

3) "Radiotherapy may be given externally or internally and can be used in combination with other treatments."

Explanation:

• Radiotherapy can be administered through two main methods: external beam radiotherapy (where radiation is directed from outside the body) and internal radiotherapy (also known as brachytherapy, where radiation sources are placed inside or very close to the tumor).
• Additionally, radiotherapy is often used in combination with other treatments such as surgery, chemotherapy, and immunotherapy, depending on the cancer type and stage.

Why the other options are incorrect:

1. "Radiotherapy uses high-energy particles to treat cancers, and it only affects cancer cells."

   • While radiotherapy uses high-energy radiation, it does not only affect cancer cells. It can also impact normal healthy cells in the treatment area, leading to side effects. The goal is to target cancer cells more effectively while minimizing damage to surrounding healthy tissue.

2. "Radiotherapy is typically given in one large dose and has minimal side effects."

   • Radiotherapy is generally administered in smaller, divided doses over several days or weeks (known as fractionation). Giving it in one large dose would increase the risk of severe side effects.

3. "Radiotherapy is not effective for treating tumors in areas that are difficult to reach."

   • Radiotherapy can often be effective in treating tumors located in difficult-to-reach areas, and techniques such as stereotactic radiosurgery and internal radiotherapy (brachytherapy) can help treat tumors in challenging locations.

The correct answer is:

3) Erythema and skin irritation at the treatment site

Explanation:

• Erythema and skin irritation are common early side effects of radiotherapy, especially in the area being treated, such as the breast in this case. These symptoms occur because radiation can cause inflammation and damage to the skin cells in the treated area.
• Weight gain, nausea and vomiting, and joint pain and stiffness are not typically early side effects of radiotherapy. These may occur later in treatment or as a result of other factors like medications or cancer-related symptoms, but skin irritation and erythema are the most immediate and common concerns in the early stages of radiotherapy.

Additional Information:

• Skin care: Patients should be advised to keep the skin in the treated area clean and moisturized. They should avoid tight clothing, scrubbing, and direct sunlight exposure.

• The HPV (Human Papillomavirus) vaccine is used to prevent infections by certain types of human papillomavirus. Persistent infection with high-risk HPV types can lead to cervical cancer.
• The vaccine is most effective when administered before individuals become sexually active, as it protects against the types of HPV that most commonly cause cervical cancer.
• There are several types of HPV vaccines available, such as Gardasil and Cervarix, which protect against the most common cancer-causing strains of HPV.

• Rationale: The Hepatitis B vaccine is used to prevent Hepatitis B virus infection, which primarily affects the liver. It does not have any role in preventing cervical cancer.

• Rationale: The Tetanus vaccine is used to prevent tetanus, a serious bacterial infection caused by Clostridium tetani. It does not provide any protection against cervical cancer.

• Rationale: While immunization is a general term for the process of administering a vaccine to stimulate an immune response, it is not specific to any particular disease. The correct term for the vaccine that prevents cervical cancer is the HPV vaccine.

• Among the given options, the HPV vaccine is the specific immunization used to prevent cervical cancer. It is crucial to follow vaccination guidelines to reduce the risk of cervical cancer and other HPV-related diseases.

• Non-communicable diseases (NCDs) are medical conditions or diseases that are not caused by infectious agents. These diseases are often chronic, meaning they last for long periods of time and progress slowly.
• Examples of NCDs include cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma), and diabetes.
• NCDs are the leading cause of death globally, responsible for a large proportion of deaths in both developed and developing countries.

• Rationale: Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites, or fungi. These diseases can be spread, directly or indirectly, from one person to another. Examples include the flu, tuberculosis, and HIV/AIDS.

• Rationale: Acute diseases are characterized by a sudden onset and a short duration. They often require urgent or short-term treatment and resolve quickly. Examples include the common cold, appendicitis, and acute bronchitis.

• Rationale: Communicable diseases are similar to infectious diseases in that they are caused by infectious agents and can be transmitted from one person to another. This term emphasizes the ability of the disease to spread in a community.

• Non-communicable diseases, also known as chronic diseases, are long-lasting medical conditions that are not caused by infectious agents. Understanding the difference between NCDs and other types of diseases is crucial for proper diagnosis, treatment, and prevention strategies.

• Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones. This deficiency can lead to a variety of clinical features that affect multiple body systems.
• High blood sugar is not a common clinical feature of hypothyroidism. It is more commonly associated with conditions such as diabetes mellitus. Hypothyroidism typically does not cause significant alterations in blood sugar levels.

• Rationale: Pleural effusion, the accumulation of fluid in the pleural cavity, can occur in hypothyroidism due to the generalized slowing of body processes and fluid retention.

• Rationale: Myxedema refers to the severe form of hypothyroidism and is characterized by the thickening and swelling of the skin and other tissues, especially in the face and extremities.

• Rationale: Carpal tunnel syndrome can occur in hypothyroidism due to the accumulation of mucopolysaccharides in the tissues, leading to compression of the median nerve.

• Among the given options, high blood sugar is not a typical feature of hypothyroidism. The other options—pleural effusion, myxedema, and carpal tunnel syndrome—are all associated with the condition due to the overall slowing of metabolic processes and the accumulation of substances in tissues.

The correct answer is Joints.

• Arthritis is the disease of Joints.

Key Points

• Arthritis:
  • The main symptoms of Arthritis are the swelling and tenderness of our joints.
  • The other symptoms of arthritis are joint pain and stiffness, which typically become worsen with age.
  • Arthritis occurs when your body's immune system attacks the tissues of the body.
  • There are two most common types of arthritis:
    • Osteoarthritis: Most common type of Arthritis.
    • Rheumatoid arthritis: Caused due to attack of the immune system on part of our body.

Additional Information

• Skin: 
  • ​The most common form of skin disease is
    • Acne
    • Eczema
    • Psoriasis 
• Kidney: 
  • ​The most common form of kidney disease is chronic kidney disease. 
    • Type 1 or type 2 diabetes
    • High blood pressure
• Liver: 
  • ​The most common types of liver infection are hepatitis viruses, including: 
    • Hepatitis A
    • Hepatitis B
    • Hepatitis C

Concept:

• As per the Centers for Disease Control and Prevention (CDC) guidelines says hand hygiene takes at least 20- 30 seconds. Duration of Hand Hygiene varies as per the type of Handwashing.

Types of Hand Washing

Social Handwashing

• It is the process of cleansing of hands from all the physical debris and to prevent from infectious diseases. It helps to remove the microorganisms from the skin surface. This is preferred when hands are visibly soiled or before eating etc.
• Duration: 20 to 30 seconds with soap and water.

Antiseptic Handwashing

• It is the procedure to maintenance od hand hygiene with the help of Anti Septic Solutions including chlorhexidine and iodine.
• This is used when hands are not visibly soiled and after touching and before touching the patient.
• Duration is at least 20 Seconds.

Surgical Hand Washing

• As the name suggests, this is used prior to sterile operations, including surgical procedures.
• This procedure mainly removes resident microorganisms that live on the surface of the skin in addition to transient microorganisms.
• Immediately after surgical handwashing surgical gloves are donned to prevent microorganisms from returning to the surface of the skin.
• Duration: is for 2–6 minutes

The correct answer is option 2, i.e. Myopia is caused due to excessive curvature of the eye lens and can be corrected by using a concave lens.

• Myopia:
  • Also known as near-sightedness.
  • The far point is nearer than infinity.
  • A person with this defect can see nearby objects but cannot see distant objects distinctly.
  • Image of the distant object is formed in front of the retina.
  • Arise due to - (a) excessive curvature of the eye lens, (b) elongation of the eyeball.
  • Correction - concave lens of suitable power.

• Hypermetropia:
  • The focal length of the eye lens is too long and can be corrected by the convex lens of suitable power.
• Presbyopia:
  • Decreases the power of accommodation and can be corrected by using bi-focal lenses.

Concept:

• Endocrine glands lack ducts and are hence, also called ductless glands. Their secretions are called hormones which are directly released into the bloodstream.
• The adrenal cortex produces three main types of steroid hormones: mineralocorticoids, glucocorticoids, and androgens.
• Mineralocorticoids (aldosterone) -> zona glomerulosa ->blood pressure and electrolyte balance.
• Glucocorticoids cortisol and cortisone -> zona fasciculata -> metabolism and immune system suppression.
• Androgens -> zona reticularis -> converted to fully functional sex hormones in the gonads

Regulation:

• Glucocorticoids are under the regulatory influence of the hypothalamus-pituitary-adrenal HPA axis. Glucocorticoid synthesis is stimulated by the adrenocorticotropic hormone ACTH.
• Mineralocorticoid secretion is regulated mainly by the renin-angiotensin-aldosterone system RAAS. The juxtaglomerular apparatus of the kidneys release the enzyme renin into the blood, which starts reactions that lead to the formation of Angiotensin II. [Mineralocorticoids are not under influence of the pituitary so even if the adrenal gland is endocrine it does not answer]

Explanation:

• The pituitary gland is the master gland of the body as it controls the functioning of many other endocrine glands.
• The pituitary gland is located in a bony cavity called Sella tursica and is attached to the hypothalamus by a stalk.
• It secretes several hormones like growth hormone (GH), prolactin (PRL), thyroid-stimulating hormone (TSH), adrenocorticotrophic hormone (ACTH), and luteinizing hormone (LH), follicle-stimulating hormone, melanocyte-stimulating hormone (MSH), oxytocin and vasopressin.
• Thyroid-stimulating hormone (TSH) stimulates the synthesis and secretion of thyroid hormones from the thyroid gland.
• In males, Luteinizing hormone (LH) stimulates the synthesis and secretion of hormones called androgens from the testis.

Hence, the two endocrine glands which secrete their hormones when they receive orders from the pituitary through its hormones are the thyroid & testis.

Mistake Points In this Question the thyroid and testis are exclusively endocrine and receive their order from the pituitary gland to secrete their hormones. The adrenal gland and part of its secretion are independent of the pituitary.

The correct answer is Eye.

Key Points

• The conjunctiva is a thin, transparent mucous membrane.
• It lines the inner surface of the eyelids and covers the sclera (the white part of the eye). 
• The conjunctiva contains glands that produce secretions that help to keep the eyes moist, and antibodies, which reduce infection.
• Conjunctivitis means ‘inflammation of the conjunctiva’.

Additional Information

• It is usual for both eyes to be affected in infectious cases. 
• Some causes include: 
  • The commonest cause is an infection by viruses or bacteria.
  • Due to chemical irritants.
  • Traditional eye remedies or allergies.

Important Points

• Effects:
  • The eyes are red and uncomfortable. 
  • Make the eyelids stick together.
  • The vision is usually not affected.

   Concept:

• Glasgow Coma Scale is the scoring system used to describe the level of consciousness in a person having a traumatic brain injury. It is used to rule out the level of acute brain injury.
• The minimum score on Glasgow Coma Scale is 3 indicates a deep coma or a brain-dead state. The maximum score is 15 which indicates a fully awake patient. 

Components of the Glasgow Coma Scale

• Eye-opening
• Motor Response
• Verbal Responses

Interpretation

 Patients with  3 to 8 scores are usually considered to be in coma. Generally, brain injury is classified as:

• Severe: GCS < 8–9
• Moderate: GCS 8 or 9–12 
• Minor: GCS ≥ 13.

Explanation-

Cushing's syndrome

• It is also known as hypercortisolism.
• It happens when there’s extra cortisol in the body.
• Signs and symptoms are high blood pressure, abdominal obesity etc.
• It can be fatal if untreated.

Additional Information

Acromegaly

• It is a hormonal disorder.
• It happens when the pituitary gland produces too much growth hormone during adulthood.
• Bones size increases which lead to increased height and are called gigantism.

Addison's disease

• It is also called adrenal insufficiency.
• It causes inadequate production of the steroid hormones cortisol and aldosterone.
• Tuberculosis is the most common cause of Addison's disease.

Pituitary dwarfism

• It is also known as growth hormone deficiency.
• It is caused by insufficient amounts of growth hormone (pituitary) in the body.
• It can be congenital or acquired.

The correct answer is inflammation in the airway.

• Asthma is an inflammatory disease of the airways to the lungs which makes breathing difficult and affects some physical activities in humans.

Key Points

• In this disease, the air passages of the lungs become too narrow because of excessive production of mucus.
• The most common symptoms of asthma include wheezing, tightness in the chest, fatigue, coughing, and shortness of breath.
• Cystic fibrosis is a hereditary disease that affects the lungs and digestive system.
• It can be life-threatening.

Additional Information 

• Pneumonia is an infection that causes the inflammation of the air sacs in one or both lungs. It is caused by a variety of organisms, including bacteria, viruses, and fungi.
• Tuberculosis (TB) is a contagious infection that attacks our lungs. It is caused by a type of bacteria called Mycobacterium tuberculosis.

Acromegaly-

• A disorder in adults in which the pituitary gland produces too much growth hormone. This leads to overgrowth of bone known as Acromegaly in adulthood.
• In childhood overproduction of growth hormone leads to an excessive increase in height known as Gigantism.
• Acromegaly is usually caused by a non-cancerous tumor. 
• Middle-aged adults are most commonly affected.
• Symptoms include enlargement of the face, hands, and feet.
• Gigantism occurs when there is an increase in the secretion of growth hormone before the fusion of the long bone epiphysis and is characterized by tall stature.
• Acromegaly occurs when hypersecretion of Growth Hormone occurs after the fusion of the epiphysis leading to large extremities and characteristic faces.
• Surgery of the Pituitary Gland cures acromegaly but in some cases, tumor size is so large to remove entirely so radiation therapy is given.

Additional Information

• Cushing Syndrome Defined:
  • A metabolic disorder caused by the overproduction of corticosteroid hormones by the adrenal cortex often involves obesity and high blood pressure.
  • The most common cause is the use of steroid drugs.
  • But it can also occur from an overproduction of cortisol by the adrenal glands.
  • Too much cortisol can produce some of the hallmark signs of Cushing syndrome :
    •  A fatty hump between your shoulders, a rounded face, and pink or purple stretch marks on your skin.
• Lack of iodine causes an abnormal enlargement of the thyroid gland which is called a goitre.
  • Thyroid Gland:
    • The hormones secreted by it are Thyroxine and Triiodothyronine.
    • Iodine is secreted in more quantity.
• Tetany is a symptom described as an involuntary contraction of muscles that leads to painful muscle cramps, spasms of the larynx, and sensory disturbances.

Concept:

• Stomach -> A muscular organ which is located on the left side of the upper abdomen.
• The stomach receives food from esophagus through lower esophageal sphincter.
• The stomach secretes acids and enzymes for the digestion of food.

Explanation:

• G-cells or Gastrin Cells responsible for the synthesis and secretion of gastrin.
• Primarily, gastrin is produced by antrum of the stomach.
• But it can also secreted by the duodenum and pancreas when stimulated by vagal efferent neurons and GRP neurons.
• Functions:
  • Enhancing gastric mucosal growth
  • Gastric motility
  • Secretion of HCL into the stomach.

Additional Information

• Cardia -> Upper portion of the stomach, prevents acidic contents of the stomach from moving upward into the esophagus.
• Fundus -> Dome shaped superior dilation of the stomach, collects digestive gases.
• Duodenum -> This also produces less amount of gastrin.